Pregnancy and multiple sclerosis: 2022 recommendations from the French multiple sclerosis society

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Vukusic, Sandra | Carra-Dalliere, Clarisse | Ciron, Jonathan | Maillart, Elisabeth | Michel, Laure | Leray, Emmanuelle | Guennoc, Anne-Marie | Bourre, Bertrand | Laplaud, David | Androdias, Géraldine | Bensa, Caroline | Bigaut, Kevin | Biotti, Damien | Branger, Pierre | Casez, Olivier | Cohen, Mikael | Daval, Elodie | Deschamps, Romain | Donze, Cécile | Dubessy, Anne-Laure | Dulau, Cécile | Durand-Dubief, Françoise | Guillaume, Maxime | Hebant, Benjamin | Kremer, Laurent | Kwiatkowski, Arnaud | Lannoy, Julien | Maarouf, Adil | Manchon, Eric | Mathey, Guillaume | Moisset, Xavier | Montcuquet, Alexis | Pique, Julie | Roux, Thomas | Marignier, Romain | Lebrun-Frenay, Christine

Edité par HAL CCSD ; SAGE Publications

International audience. Objective: The objective of this study was to develop evidence-based recommendations on pregnancy management for persons with multiple sclerosis (MS). Background: MS typically affects young women in their childbearing years. Increasing evidence is available to inform questions raised by MS patients and health professionals about pregnancy issues. Methods: The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and university databases (January 1975 through June 2021). The RAND/UCLA appropriateness method was developed to synthesise the scientific literature and expert opinions on healthcare topics; it was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence. Results: A strong agreement was reached for all 104 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, locoregional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses and disease-modifying treatments. Conclusion: The 2022 recommendations of the French MS society should be helpful to harmonise counselling and treatment practice for pregnancy in persons with MS, allowing for better and individualised choices.

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